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1 178 Review DO I: /tpa Usage of Turkish language in medical literature and frequent errors Cengiz Yakıncı, Özgü Suna Celiloğlu, Belgin Aksu* İnönü University Department of Pediatrics, Malatya, Turkey *Turkish Language Institute - Specialist of Turkish Language Summary Language is an instrument for handing down the thoughts, scientific acquirements, poetic and literary products. The initial efforts for determining suitable Turkish counterparts against foreign words and terms have began during the Republican Era. Mustafa Kemal Atatürk, with an educational vision beyond his epoch, has promoted Turkish language as a scientific language instead of Persian and Arabic languages and thus conquered our language s independence. In the information age which we are living today, the communities should improve and support their national language of science in order to use the existing data and to make scientific facts available for each individual in the community. The frequently-encountered cases in medical literature that are inappropriate for Turkish language are classified as follows: the foreign terms and words used in spite of an existing Turkish counterpart, ignoring methods for derivation of Turkish terms, translation mistakes, faults in spelling, words denoting different meanings with similar way of writings. The usage of Turkish terms within the academic level, thesis of proficiency and literary products and maintaining writing skills suitable for the Turkish language spelling rules are important for our language to become a scientific language. Efforts for pioneering and becoming a precedent are required. (Turk Arch Ped 2011; 46: ) Key words: Turkish, medical literature, language Introduction Language is an instrument for handing down the thoughts, scientific acquirements, poetic and literary products. Populations can only be productive with the presence of their languages and cultures and can contribute to humanity (1). The common property constituting a nation is maintained by its language (2). Whatever language a person talks he/she thinks in that language and expresses himself/herself in that language in the best way (3). When a patient can not understand his/her physician, he/she loses his/her trust, recedes form the physician and refers to people who understands his/her native language and whom he/she understands for treatment (4). There are data proving that the language which has the oldest written data among living languages worlwide is Turkish (5). In the Turkish history, the Turkish language was used as a scientific language for the first time in medicine (6). This was caused by the requirement that the reference source for prevention of diseases and patient care should be in the native language (7). The initial efforts for determining suitable Turkish counterparts against foreign words and terms have began during the Republican Era (8). Mustafa Kemal Atatürk, with an educational vision beyond his epoch, has promoted Turkish language as a scientific language instead of Persian and Arabic languages and conquered our language s independence in this way (9). He derived geometry terms with their roots and annexes including eksi, çarpı, bölü, çarpma, bölme, eğri, doğru, üçgen, dörtgen, açı, açıortay, üçgenin iç açıları toplamı (plus, minus, division, multiply, divide, curve, straight line, triangle, quadrangle, angle, bisector, sum of internal angles of a triangle) and brought 129 new words to the turkish language (10,11). Terms are words corresponding to a specific and certain concept related to science, art, occupation or any subject. Terms are also the words of the natural language. To be a term does not mean that the word has lost its property of being an ordinary word of the natural language (12). In the information era in which we live, national scientific language should be developed and supported for the populations to use their present data and scientific facts to reach each individual in the population (13). We arranged this article with the objectives of emphasizing the importace of use of Turkish terms in publications and noting Ad dress for Cor res pon den ce: Özgü Suna Celiloğlu MD, İnönü University Department of Pediatrics, Malatya, Turkey Re cei ved: Ac cep ted: Tur kish Arc hi ves of Pe di at rics, pub lis hed by Ga le nos Pub lis hing.

2 Turk Arch Ped 2011; 46: The use of Turkish language on medical literature 179 frequent errors and the points which should be cared about to prevent these errors for our language to become a scientific language and not to lose its richness. The terms which are inappropriate for the Turkish language and which we encounter in medical articles are discussed below (Table 1). 1- Terms and words which are not used, although the Turkish counterparts are present. Use of foreign terms and words in articles in spite of an existing Turkish counterpart is frequently encountered. Foreign terms and words frequently used because of habitude in spite of an existing Turkish counterpart are sampled in Table-2. Some words emphasized under the title of When the Turkish counterpart exists in the journal of the Turkish Pediatric Archive are as follows: primer-birincil (primary), sekonder-ikincil (secondary), santral-merkezi (central), spontane-kendiliğinden (spontaneously), vaka-olgu (case) (vaka: olay (event), vakıa: olgu (case)), faktör-etmen (factor), lokal yerel (local), parametre-değişken (parameter), method-yöntem (method), kriter-ölçüt (criterion (14). In a study performed by Yavuz (15), titles and introduction and objective parts of 50 speech texts and 115 posters included in the XIV.th National Allergy and Clinical Immunology Congress book published in 2006 were examined in terms of use of Turkish. 32% of a total of 5160 words (1698 words) were found to be foreign and 46% of these foreign words (793 words) were found to have Turkish counterparts. 2- Ignoring derivation methods of Turkish terms Turkish is an affixed language. Successive affixes constitute the greatest property of the Turkish language and generally of all affixed languages (16). Its structure is clear, understandable and grammatical. It has affixes which are appropriate to derive about 170 terms (15). It is thought that with this property about 2 million new words and terms can be derived (17). Although it has such a rich background, there are words which have been affixed according to the mode of affixion in foreign languages and which are not appropriate for the structure of the Turkish language. Prefixes: In Turkish words, there is no structure which is called prefix. Affixes are in the end of the word (18). Prefix of anti- : Counterparts for the words including antiallergic (antialerjik-alerjiönler), antipyretic (antipiretik-ateşdüşürür), antiseptic (antiseptic-mikropkıran), antiproliferative (antiproliferatif-çoğalımönler), anticoagulant (antikoagülanpıhtıönler), antidiabetic (antidiyabetik-şekerdüşürür), antiemetic (antiemetik-kusmakeser) can be found by using derivation Table 1. The terms and words which are inappropriate for the Turkish language used in medical articles 1. Terms and words which are not used, although the Turkish counterparts are present. 2. Ignoring derivation methods of Turkish terms 3. Translation errors 4. States which are not appropriate for spelling rules 5. Words with similar spelling and different meanings methods of Turkish terms and new terms can be derived using guides for terms. Prefixes of pre- and post- : These are used in a way which is not in accordance with the rules of use of the Turkish language. For prefix of pre- we can use the words ilk and ön, önce (19). Nöbet öncesi instead of prenöbet (preseizure), nöbet sonrası instead of postnöbet (postseizure) and operasyon öncesi instead of preoperatif and operasyon sonrası instead of postoperatif (postoperative) would be a more appropriate use for the Turkish language. Suffixes: In Turkish, suffixes are used. However, sometimes foreign suffixes can be used at the end of the words which have become Turkish. Suffix of -sit : Words which are used with the suffix of -sit can be counterparted with the word of kıran. Examples include bakterisit-bakterikıran (bactericid), tenyasit-tenyakıran (teniacide), insektisit-böcekkıran (insecticide). -metre: the word ölçer can be used as a counterpart for the word of metre. Examples include kalorimetre-ısıölçer (calorimeter), termometre-sıcaklıkölçer (thermometer). Suffix of en: It is a suffix which produces an adverv in the Arabic language. The word haricen (externally) which is derived form the word hariç is therefore not appropriate for the Turkish language. Use of the word dışarıdan instead of haricen is more appropriate (18). To give an example, instead of noting haricen kullanılır (used externally) for creams and lotions, an expression of dışarıdan kullanılır would be more appropriate. Instead of noting haricen kız, haricen erkek Table 2. Terms and words which have Turkish counterparts USED adolesan agregasyon agreve etmek aksidental demarkasyon direkt diüretik dominant emboli etik frekans hipertansiyon kronik manuel prematüre progresif prospektüs terapi baypas stent TURKISH ergen (adolescent) kümelenme (aggregation) şiddetlendirmek (aggravate) rastlantısal (accidental) sınır (demarcation) doğrudan (direct) idrarsöker (diuretic) baskın (dominant) damar tıkanıklığı (emboly) ahlak (ethics) sıklık (frequency) yüksek kan basıncı (hypertension) süreğen (chronic) elle işletilen (manual) erken doğan (premature) ilerleyici (progressive) tanıtmalık (prospectus) tedavi (therapy) köprüleme (baypass) kafes (stent)

3 180 The use of Turkish language on medical literature Turk Arch Ped 2011; 46: Table 3. Examples of words produced by use of derivation methods of Turkish terms. USED antialerjik antipiretik antiseptik antiproliferatif antikoagülan prenöbet postnöbet preoperatif bakterisit tenyasit insektisit kalorimetre termometre haricen afebril TURKISH alerjiönler (antiallergic) ateşdüşürür (antipyretic) mikropkıran (antiseptic) çoğalımönler (antiproliferative) pıhtıönler (anticoagulant) nöber öncesi (pre-seizure) nöbet öncesi (pre-seizure) operasyon öncesi (preoperative) bakterikıran (bactericide) tenyakıran (teniacide) böcekkıran (insecticide) ısıölçer (calorimeter) sıcaklıkölçer (thermometer) dışarıdan (external) ateşsiz (afebrile) (externally female, externally male) in the examination of external genital organs, expressions of kız dış görünümünde, erkek dış görünümünde can be used. In Table 3, examples of words produced by use of derivation methods of Turkish terms. 2- Translation errors The words which have become international with scientific developments, which are used commonly in our language and for which no Turkish counterparts could be found yet should be written as they are read. In other words, the Turkish language is a phonetic language. It is read as it is written and written as it is read. As in the example of etyoloji-etiyoloji (etiology), there are no word groups with special pronunciation in our language (i.e. in english: ei, ae, ie, ch, tsch, tz). The letters are read individually (20). The words interferon (interferon), serum (serum), influenza (influenza), vitamin (vitamin), globulin (globulin) originate from Latin and even the work terim (term) originate from Latin. Exchange of words and concepts between languages can not be prevented. The important point is to make the words coming from foreign languages Turkish (21). Expressions like erken çocukluk, geç çocukluk are not Turkish. If they are used as counterparts for the english words early childhood, late childhood it is translated falsly. To translate these as küçük çocuklarda, büyük çocuklarda would be more appropriate for our language (15). There are no definitions like erken çocukluk, geç çocukluk in the section of childhood periods in the book named Pediyatri (Pediatrics) edited by Neyzi (22) published in Turkish words do not end with the letters of b or d ; corticosteroid should be written as kortikosteroit, thyroid should be written as tiroit, lipid should be written as lipit, nucleotide should be written as nükleotit, method should be written as metot, etude should be written as etüt, standard should be written as standart, lobe should be written as lop and myocard should be written as miyokart (18). In the words translated into Turkish, the consonant -y which is the combining letter is used between two vowels like -i, -a or i, -e when writing in accordance with Turkish reading. Examples include kardiak-kardiyak (cardiac), anjiografi-anjiyografi (angiography), kranialkranyal (cranial), psikiatri-psikiyatri (psychiatry), diabetdiyabet (diabetes), pediatri-pediyatri (pediatrics), laboratuarlaboratuvar (laboratory), ürolitiazis-ürolityazis (urolithiasis), idiopatik-idiyopatik (idiopahtic), diastol-diyastol (diastole) and psoriasis-psoriyazis (psoriasis). According to the Turkish spelling checker words do not start with letter groups including py-, my- etc. While these letters are half vowels in the original languages the belong, they are consonants in Turkish. By putting a i in between they can be written as they are read (like piyelografi, miyelografi). If one wants to be true to the original Latin language, the situation is different: examples include multiple myeloma, myasthenia and they are preferably written in italics. The habit of using foreign words frequently causes wrong writing including konstrüksiyon (construction) instead of konstriksiyon (constriction), strüktür (structure) instead of striktür (stricture) and fatal (fatal) instead of fötal (fetal). Some words which are frequently used erroneously in articles include: Abse-apse (abcess), tetanoz-tetanos (tetanus), dekompanze-dekompanse (decompensated), gangren-kangren (gangrene), glukoz-glikoz (glucose), gradient-gradyan (gradient), kataterizasyon-kateterizasyon (catheterization), konjesyon-konjestiyon (congestion), kontraendikasyon-kontrendikasyon (contraindication), prematür-prematüre (premature), antiasit-antasit (antacid) and zigzag-zikzak (zigzag) (23). In the vocal fremitus method which is a medical examination method used for examination of the lungs, as the patient repeates a simple word which would produce a sound of n from the nasal passage, the physician puts his/her hands on the back of the patient, feels the vibration with his /her hands and makes the necessary evaluation. In French, the words are repeated for this examination. In English, the words are prefered. In Turkey, the patients are made to repeat the words Although there are tousands of words which would produce a sound coming from the nasal passage, we solved the problem by translating the French words (24). This problem solving led to an examination method which is not appropriate for the objective. The word maruziyet which is frequently used to mean maruz kalmak (exposure) is derived from the word maruz which is an Arabic word. However, there is no word maruziyet in either Turkish or Arabic (23). 4- States which are not appropriate for spelling rules a) Word series which are not appropriate for noun phrases Some phrases used in Turkish are being translated directly from a foreign language. For example, it would be more appropriate to use the expression Sinüzitten sorumlu bakteriyel etkenler hastaların %60 ında gözlenir without changing the order of the words constituting the defined noun phrase instead of Sinüzitten sorumlu bakteriyel etkenler %60 hastada gözlenir.

4 Turk Arch Ped 2011; 46: The use of Turkish language on medical literature 181 Similarly, vitamin names are also used erroneously including vitamin C, vitamin D or even C vit, D vit. Considering the accordance of the words constituting the phrase, use of C vitamini, D vitamini would be more appropriate (18). In titles of radiology reports, erroneous use of phrases are seen including IVP tetkik and BT tetkik. It is appropriate to use IVP tetkiki and BT tetkiki (adding the affixes of the phrases) (25). Similarly, noun phrases translated from French should be in accordance with the Turkish word index. For example, colic renal-böbrek koliği (renal colic), tuşe rectal- rektal tuşe (rectal examination). If these words have to be used, they can be written in italics sticking to the original nouns (in situ, in vivo) with quotation marks (20). b) Names of causative agents in microbiology and parasitology In microbiology, if causative agents include only species name and does not include genus name, they are written in Latin and in italics. For example, Staphylococcus. In taxonomic classification, species name is Staphylococcus and genus name is aureus. Species names are written in capitals and genus names are written in small letters. If only the species will be noted, the first letters are written as small letters (examples include enterokok, streptokok, stafilokok). c) Correction marks Correction Marks are used to seperate two words with different meanings, but the same spelling. They may not be used, if confusion will not be created when not used. The words hal and adet are the best examples for this. Since the word hal in the sentence Halden alınan sebzelerde enfeksiyon olasılığı nedeniyle sebzelerin yıkanması dikkatli yapılmalıdır. means vegetable market, correction mark is not used. In the sentence Hastanın hâlinden çok haberdar olunamayabilir the word hal means state, correction mark should be used. Some of the correction marks used previously are not used any more, since no confusion exists. The words ilaç, lazer, ahlak, cerrahi, tıbbi and adli are used without correction marks. d) Abbreviations Abbreviations should be written using the first letters of the Turkish words instead of the English words (ie. CT (Computarized tomography) should be written as BT (bilgisayarlı tomografi). The word örneğin (for example) which we frequently use should be written as ör. instead of örn.. ve benzeri (etc.) should be written as vb. instead of v.b.. Similarly, the abbreviation for the word gram should be g instead of gr.. When confusion about abbreviations is present, the rules of the Turkish Language Institute should be considered (26). Affixes added to abbreviations composed of capitals should be used according to the reading of the capitals. AEİ tan (antiepileptik ilaçtan) is a wrong use. It should be written as AEİ den. In abbreviations formed with small letters, the affixes are formed according to the reading of the original word ( Doğum ağırlığı 1000 g dan düşük bebeklerde instead of Doğum ağırlığı 1000 g den düşük bebeklerde ). e) Decimal numbers In Turkish, decimal numbers are written using comma instead of point. Comma should be used in sentences like serum potasyum değeri 3,5 saptanmıştır instead of serum potasyum değeri 3.5 saptanmıştır (27). f) Conjugated words The information in the third item in the section of conjugated words is as follows: When the meaning of both words or the second word changes in the way of similitude, these conjugated words are written connected (28). Conjugated words with a structure of undefined noun phrase should be written adjacently (examples include aslanağzı, kuşburnu, yavruağzı, bülbülyuvası, Japonbayrağı, tahtapapuç, eklemfaresi, omuriliksoğanı, belsoğukluğu, aybaşı, itdirseği, kunduracıgöğsü, güvercingöğsü, kafatası, çatıkemiği, soyağacı). In subordinatives formed based on similitude, the first word causes a change in meaning of the second word, so they should be written adjacently (18). Examples include alabacak, başparmak, yeleboyun, çekiçparmak, tüfektetiği, kabakulak, örümcekparmak. 5) Words with similar spelling and different meanings Efforts of producing Turkish words and terms have been generally based on meanings, points related to grammar have not been considered, many words which could be brought to the language with antagonism have been wasted and lost. The words yetmezlik and yetersizlik are examples for this. The word yeterlik which is a noun derived from a verb has been added an affix of -li and it has become an adjective. Then it has become an abstract noun with the affix of -lik. In parallel to the form of yeterlilik the word yetersizlik was derived. The forms of yetmezli and yetmezlilik have not been utilised. Yetmezlik means a state of not being able to suffice in spite of all efforts. Yetersizlik means is a state of insufficiency which is reversible and which can be intervened. It can be expressed as Kalp yetmezliği söz konusu olduğunda hasta ölür ama kalp yetersizliği çeşitli tıbbi müdahalelerle önlenir In some cases, confusion in use occurs because of common sounds. Özgül means spesifik (specific), özgün means orijinal (original). For example, mongoloid face is specific (özgül) for Down syndrome and presence of Y chromosome is original for the male gender. Confusion while speaking of these two words can sometimes also be observed in articles. Similarly, etkin means devinimli, işleyen, çalışan, etkisi görürlen-duyulan, faal-aktif (active); examples can be given like Işık tedavisi sarılıkta etkin bir tedavidir., Bir ön enzimin etkin enzim hâline dönüşmesi için Kullanılan ilaçların etkin doz aralığı belirlenmelidir. Etken (factor) means something that contribute to an outcome. Examples can be given like Etken maddesi farklı ilaçlar olup etkileri aynı olan ilaçlar mevcuttur. Alerjisine polenler etken olmaktadır. Çocukların çoğunun başarısında aile içerisinde gördükleri sevgi ve ilgi etken olmaktadır. Besides, a living organism causing a disease is also called etken (agent). For example; Alınmış olan kan kültürlerinde etken Staphylococcus aureus olarak tespit edilmiştir (the causative agent has been found to be Staphylococcus aureus in hemoculture) (8).

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